title: Another quality assurance issue--amended reports: what do we really know about them?
abstract: The Clinical Laboratory Improvement Amendment (CLIA) of 1988 requires that if a cytology/histology discrepancy is discovered which is significant and affects patient care, an amended report should be issued (Clinical Laboratory Improvement Amendments, Fed Reg 1992;57:7169). Since little is known about such amended reports, a survey was developed to assess how individuals handle discrepancies. The Quality Assurance Task Force from the Papanicolaou Society of Cytopathology created a survey to assess these methods and sent it to all of their members. Fifty-one individuals responded to the survey. Methods vary widely among institutions. On average, 107 cytologic/histologic correlations are performed each month with the discovery of approximately 2 major and 11 minor discrepancies. Thirty-nine responders utilize written amended reports and telephone clinicians when a major discrepancy is found. Thirty-eight individuals indicated that their place of employment has a written policy concerning discrepancies. Time spent in quality assurance issues averaged 8 hr per wk for cytotechnologists and 3 hr per wk for pathologists. Although amended reports are required when significant discrepancies are revealed, a standard practice does not exist.
authors.affiliation: Department of Pathology, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298, USA.
authors.forename: J F
authors.initials: JF
authors.lastname: Stastny
authors.forename: K R
authors.initials: KR
authors.lastname: Geisinger
authors.forename: C W
authors.initials: CW
authors.lastname: Michael
authors.forename: S S
authors.initials: SS
authors.lastname: Raab
authors.forename: C N
authors.initials: CN
authors.lastname: Powers
authors.forename: R M
authors.initials: RM
authors.lastname: Davila
mesh_terms: D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D011785:Quality Assurance, Health Care; D012308:Risk Management / Q000379:methods*; D011795:Surveys and Questionnaires; D014626:Vaginal Smears / Q000592:standards*